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Microorganisms
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Research in Hospital Infection Control 2.0
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Research in Hospital Infection Control 2.0

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 9599

Special Issue Editor

Dr. Brian Crook

E-Mail Website
Guest Editor
Health and Safety Executive Science and Research Centre, Buxton, UK
Interests: hospital infection; virus disease outbreak; healthcare worker protection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the continuation of our 2020 Special Issue “Research in Hospital Infection Control”.

Infection control in healthcare settings is of paramount importance, not only to protect vulnerable patients, but also for healthcare staff. Effective infection control interventions could potentially save patients from serious health complications that could prolong hospital stays, creating pressure on bed capacity and adding to the cost of healthcare provision. They also allow healthcare staff to continue their care provision with confidence.

Never had hospital infection control been more critical, or been of such a high profile, than during the COVID-19 pandemic. Amidst a plethora of information, advice, and guidance ranging in quality, what were the most important and effective interventions and what have they taught us for future interventions? Undoubtedly, they will be a combination of measures, including hygiene practices, supported by appropriate personal protective equipment, tailored to the needs of the care provision and healthcare settings.

Dr. Brian Crook
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hospital infection control
  • hospital acquired infection
  • healthcare worker
  • personal protective equipment, hygiene
  • disease transmission
  • disinfection
  • COVID-19

Published Papers (6 papers)

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Research

12 pages, 1711 KiB  
Article
Ten-Year Analysis of Bacterial Colonisation and Outcomes of Major Burn Patients with a Focus on Pseudomonas aeruginosa
by Jenny Gomersall, Kalani Mortimer, Deniz Hassan, Kathryn A. Whitehead, Anthony J. Slate, Steven F. Ryder, Lucy E. Chambers, Mohamed El Mohtadi and Kayvan Shokrollahi
Microorganisms 2024, 12(1), 42; https://doi.org/10.3390/microorganisms12010042 - 25 Dec 2023
Viewed by 796
Abstract
A retrospective descriptive study included patients admitted with severe burns over the course of 10 years (2008–2018). Across all patients, there were 39 different species of bacteria, with 23 species being Gram-negative and 16 being Gram-positive bacteria, with also five different species of [...] Read more.
A retrospective descriptive study included patients admitted with severe burns over the course of 10 years (2008–2018). Across all patients, there were 39 different species of bacteria, with 23 species being Gram-negative and 16 being Gram-positive bacteria, with also five different species of fungi cultured. Pseudomonas aeruginosa was the most commonly isolated organism, with 57.45% of patients having a positive culture. There was a significant difference in the number of P. aeruginosa isolated from patients that acquired their burns at work, in a garden, inside a vehicle, in a garage or in a public place. In patients that were positive for P. aeruginosa, the number of operations was higher (2.4) and the length of stay was significantly increased (80.1 days). Patients that suffered from substance abuse demonstrated significantly higher numbers of isolated P. aeruginosa (14.8%). Patients that suffered from both mental health illness and substance abuse demonstrated significantly higher numbers of P. aeruginosa isolated (18.5%). In the P. aeruginosa-negative group, there were significantly fewer patients that had been involved in a clothing fire. Furthermore, in the P. aeruginosa-negative patient cohort, the mortality rate was significantly higher (p = 0.002). Since the incidence of P. aeruginosa was also associated with a decreased mortality rate, it may be that patients admitted to hospital for shorter periods of time were less likely to be colonised with P. aeruginosa. This study demonstrates novel factors that may increase the incidence of P. aeruginosa isolated from burn patients. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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19 pages, 1200 KiB  
Article
Pneumococcal Serotypes Associated with Community-Acquired Pneumonia Hospitalizations in Adults in Spain, 2016–2020: The CAPA Study
by Rosario Menéndez, Antoni Torres, Pedro Pablo España, Jose Alberto Fernández-Villar, José María Marimón, Raúl Méndez, Catia Cilloniz, Mikel Egurrola, Maribel Botana-Rial, María Ercibengoa, Cristina Méndez, Isabel Cifuentes and Bradford D. Gessner
Microorganisms 2023, 11(11), 2781; https://doi.org/10.3390/microorganisms11112781 - 16 Nov 2023
Cited by 1 | Viewed by 1198
Abstract
Newer higher valency pneumococcal conjugate vaccines (PCVs) have the potential to reduce the adult community-acquired pneumonia (CAP) burden. We describe the evolution and distribution of adult community-acquired pneumonia (CAP) serotypes in Spain, focusing on serotypes contained in the 20-valent PCV (PCV20). This was [...] Read more.
Newer higher valency pneumococcal conjugate vaccines (PCVs) have the potential to reduce the adult community-acquired pneumonia (CAP) burden. We describe the evolution and distribution of adult community-acquired pneumonia (CAP) serotypes in Spain, focusing on serotypes contained in the 20-valent PCV (PCV20). This was a prospective, observational study of chest X-ray (CXR)-confirmed CAP in immunocompetent adults hospitalized in one of four Spanish hospitals between November 2016 and November 2020. Pneumococci were isolated from cultures and detected in urine using BinaxNow® and Pfizer serotype-specific urinary antigen tests UAD1 and UAD2. We included 1948 adults hospitalized with CXR-CAP. The median age was 69.0 years (IQR: 24 years). At least one comorbidity was present in 84.8% (n = 1653) of patients. At admission, 76.1% of patients had complicated pneumonia. Pneumococcus was identified in 34.9% (n = 680) of study participants. The PCV20 vaccine-type CAP occurred in 23.9% (n = 465) of all patients, 68.4% (n = 465) of patients with pneumococcal CAP, and 82.2% (83/101) of patients who had pneumococcus identified by culture. Serotypes 8 (n = 153; 7.9% of all CAP) and 3 (n = 152; 7.8% of all CAP) were the most frequently identified. Pneumococcus is a common cause of hospitalized CAP among Spanish adults and serotypes contained in PCV20 caused the majority of pneumococcal CAP. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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24 pages, 1300 KiB  
Article
Microbiological Analysis of Surgeons’ Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study
by Artur Serra Neto, Sirlei G. Marques, Maria Rosa Q. Bomfim, Silvio G. Monteiro, Rosangela C. de Souza and Rodolfo A. Nunes
Microorganisms 2023, 11(8), 1895; https://doi.org/10.3390/microorganisms11081895 - 27 Jul 2023
Viewed by 1363
Abstract
Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms [...] Read more.
Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician’s hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus, representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia, Acinetobacter baumanii, Pseudomonas aeruginosa, Pseudomonas gessardi, Pantoea septica, Serratia marcescens, and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons’ hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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12 pages, 683 KiB  
Article
Phenotypic Variation in Clinical S. aureus Isolates Did Not Affect Disinfection Efficacy Using Short-Term UV-C Radiation
by Birte Knobling, Gefion Franke, Laura Carlsen, Cristina Belmar Campos, Henning Büttner, Eva M. Klupp, Philipp Maximilian Maurer and Johannes K. Knobloch
Microorganisms 2023, 11(5), 1332; https://doi.org/10.3390/microorganisms11051332 - 18 May 2023
Cited by 1 | Viewed by 1241
Abstract
Pigmentation, catalase activity and biofilm formation are virulence factors that cause resistance of Staphylococcus aureus to environmental stress factors including disinfectants. In recent years, automatic UV-C room disinfection gained greater importance in enhanced disinfection procedures to improve disinfection success in hospitals. In this [...] Read more.
Pigmentation, catalase activity and biofilm formation are virulence factors that cause resistance of Staphylococcus aureus to environmental stress factors including disinfectants. In recent years, automatic UV-C room disinfection gained greater importance in enhanced disinfection procedures to improve disinfection success in hospitals. In this study, we evaluated the effect of naturally occurring variations in the expression of virulence factors in clinical S. aureus isolates on tolerance against UV-C radiation. Quantification of staphyloxanthin expression, catalase activity and biofilm formation for nine genetically different clinical S. aureus isolates as well as reference strain S. aureus ATCC 6538 were performed using methanol extraction, a visual approach assay and a biofilm assay, respectively. Log10 reduction values (LRV) were determined after irradiation of artificially contaminated ceramic tiles with 50 and 22 mJ/cm2 UV-C using a commercial UV-C disinfection robot. A wide variety of virulence factor expression was observed, indicating differential regulation of global regulatory networks. However, no direct correlation with the strength of expression with UV-C tolerance was observed for either staphyloxanthin expression, catalase activity or biofilm formation. All isolates were effectively reduced with LRVs of 4.75 to 5.94. UV-C disinfection seems therefore effective against a wide spectrum of S. aureus strains independent of occurring variations in the expression of the investigated virulence factors. Due to only minor differences, the results of frequently used reference strains seem to be representative also for clinical isolates in S. aureus. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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11 pages, 1011 KiB  
Article
Short-Wave Ultraviolet-Light-Based Disinfection of Surface Environment Using Light-Emitting Diodes: A New Approach to Prevent Health-Care-Associated Infections
by Helena Duering, Thomas Westerhoff, Frank Kipp and Claudia Stein
Microorganisms 2023, 11(2), 386; https://doi.org/10.3390/microorganisms11020386 - 02 Feb 2023
Cited by 3 | Viewed by 1891
Abstract
Ultraviolet (UV)-C irradiation is a promising method for microbial eradication on surfaces. Major developments have taken place in UV-C light-emitting diodes (LEDs) technology. In this study, we examined the suitability of UV-C LED-based surface disinfection in hospitals. We tested the efficacy of UV-C [...] Read more.
Ultraviolet (UV)-C irradiation is a promising method for microbial eradication on surfaces. Major developments have taken place in UV-C light-emitting diodes (LEDs) technology. In this study, we examined the suitability of UV-C LED-based surface disinfection in hospitals. We tested the efficacy of UV-C LED surface treatment on different microorganisms dried on a carrier surface or in a liquid solution. The influences of soiling, shading, surface material, radiation wavelength, microbial load and species on the disinfection performance were investigated. UV-C LED caused a reduction of >5 log10 levels of E. coli, S. aureus and C. albicans, whereas 3 log10 reduction was observed for G. stearothermophilus spores. The components of the medium led to a reduced UV-C LED efficiency compared to buffered solutions. We observed that the microbial load and the roughness of the carrier surface had a major influence on the UV-C LED disinfection efficiencies, whereas shading had no impact on inactivation. This study showed that UV-C is suitable for surface disinfection, but only under certain conditions. We showed that the main factors influencing microbial inactivation through UV-C light (e.g., intrinsic and extrinsic factors) had a similar impact when using a UV-C LED radiation source compared to a conventional UV-C lamp. However, the potential of LEDs is contributed by their adjustable wavelength and customizable geometry for the decontamination of medical devices and surfaces, and thereby their ability to overcome shading effects. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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14 pages, 5012 KiB  
Article
Simulating the Environmental Spread of SARS-CoV-2 via Cough and the Effect of Personal Mitigations
by Claire Bailey, Paul Johnson, Josh Moran, Iwona Rosa, Jodi Brookes, Samantha Hall and Brian Crook
Microorganisms 2022, 10(11), 2241; https://doi.org/10.3390/microorganisms10112241 - 12 Nov 2022
Cited by 2 | Viewed by 2282
Abstract
Background: A cough is known to transmit an aerosol cloud up to 2 m. During the COVID-19 pandemic of 2020 the United Kingdom’s National Health Service (NHS), other UK government agencies and the World Health Organization (WHO) advised people to cough into their [...] Read more.
Background: A cough is known to transmit an aerosol cloud up to 2 m. During the COVID-19 pandemic of 2020 the United Kingdom’s National Health Service (NHS), other UK government agencies and the World Health Organization (WHO) advised people to cough into their elbows. It was thought that this would reduce viral spread and protect the public. However, there is limited peer reviewed evidence to support this. Objectives: To determine if cough related interventions reduce environmental contamination, protecting members of the public from infection. Methods: Scientists and engineers at the Health and Safety Executive (HSE) laboratory used a human cough simulator that provided a standardised cough challenge using a solution of simulated saliva and a SARS-CoV-2 surrogate virus; Phi6. Pseudomonas syringae settle plates were used to detect viable Phi6 virus following a simulated cough into a 4 × 4 m test chamber. The unimpeded pattern of contamination was compared to that when a hand or elbow was placed over the mouth during the cough. High speed back-lit video was also taken to visualise the aerosol dispersion. Results and Discussion: Viable virus spread up to 2 m from the origin of the cough outwards in a cloud. Recommended interventions, such as putting a hand or elbow in front of the mouth changed the pattern of cough aerosol dispersion. A hand deflected the cough to the side, protecting those in front from exposure, however it did not prevent environmental contamination. It also allowed for viral transfer from the hand to surfaces such as door handles. A balled fist in front of the mouth did not deflect the cough. Putting an elbow in front of the mouth deflected the aerosol cloud to above and below the elbow, but would not have protected any individuals standing in front. However, if the person coughed into a sleeved elbow more of the aerosol seemed to be absorbed. Coughing into a bare elbow still allowed for transfer to the environment if people touched the inside of their elbow soon after coughing. Conclusions: Interventions can change the environmental contamination pattern resulting from a human cough but may not reduce it greatly. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control 2.0)
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